Provider Demographics
NPI:1154159127
Name:SWEET, COURTNEY L
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:L
Last Name:SWEET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 PINE BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-9479
Mailing Address - Country:US
Mailing Address - Phone:318-372-1349
Mailing Address - Fax:
Practice Address - Street 1:782 PINE BLUFF RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-9479
Practice Address - Country:US
Practice Address - Phone:318-372-1349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203384163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine